HPV genoprevalence and HPV knowledge in young women in Mongolia, five years following a pilot 4vHPV vaccination campaign

Abstract

Background In a 2012 pilot, 9111 Mongolian girls aged 11–17 years received three doses of the quadrivalent (4vHPV) vaccine, Gardasil ® . This is the first study to measure early vaccine effectiveness and assess knowledge and attitudes of young women in Mongolia in relation to the human papillomavirus (HPV), the vaccine and cervical cancer. Methods A cohort of women vaccinated in 2012 (n = 726) and an unvaccinated cohort (n = 790) provided self-administered vaginal swabs for detection of high-risk HPV genotypes 16, 18/45, 31, 33, 35, 39, 51, 52, 56, 58, 59, 66, 68 five years following vaccination. Participant knowledge and attitudes were assessed through a questionnaire. Results A total of 1882 questionnaires and 1516 self-administered vaginal swabs were analyzed. The prevalence of any HRHPV was 39.5% among both cohorts. The prevalence of vaccine-targeted HPV types was significantly lower in the vaccinated cohort than unvaccinated: 4.8% and 17.2% respectively. The 4vHPV was shown to be protective against HRHPV 16, 18/45 with 75% vaccine effectiveness. Participant knowledge was low. Conclusions This study demonstrates that the 4vHPV is associated with reduced vaccine-targeted HPV detection rates in young Mongolian women. The questionnaire results highlight a need for awareness-raising initiatives in Mongolia on HPV, the vaccine and cervical cancer.

Human Papillomavirus Vaccination After COVID-19

“…Recent modeling data suggest that this crisis is estimated to result in a further 5000 cervical cancer deaths based on the current screening coverage of 30%-40% ( 45 ). A pilot HPV vaccine introduction program in Mongolia, where the cervical cancer burden is one of the highest in Asia ( 46 ), was also disrupted because of unsubstantiated negative claims about the vaccine, resulting in one-third of target population missing out ( 47 ). It was only after years of strong advocacy from health professionals and researchers, as well as quality local data on the effectiveness of HPV vaccine, that the Mongolian government is now considering introducing the vaccine nationally ( 47 , 48 ).…”

Postvaccination prevalence of vaccine‐Human Papillomavirus (vHPV) genotypes among the target population: A systematic review and meta‐analysis

“…The selected studies were carried out in Australia, Europe, Asia, and the United States. [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Two studies from Mongolia situated in central Asia and Bhutan, in south-central Asia were qualified. 16,18 Another multicentric cohort study included vaccinated women from Brazil and Nordic countries.…”

A Review of the Implementation Status of and National Plans on HPV Vaccination in 17 Middle-Income Countries of the WHO Western Pacific Region

“…Table 4 presents a summary of the implementation status of HPV vaccination in the 17 MICs as of July 2021 [19,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. Four countries (Federated States of Micronesia, Marshall Islands, Malaysia, and Fiji) were placed in the scale-up group, having a national HPV vaccination program for over five years.…”

“…Among the 10 countries yet to introduce HPV vaccination, seven (China, Vietnam, Cambodia, Mongolia, Papua New Guinea, Vanuatu, and Kiribati) were placed in the preparation group, having completed one or more demonstration projects. The projects' outcomes were generally reported as good with high vaccination coverage of the target population, barring Mongolia where community resistance was observed during the vaccination campaign (Table S1) [19,32,[34][35][36][37][38][39][40][41][42][43][44][45][46]. The remaining three (the island countries of Samoa, Tonga, and Tuvalu) had neither conducted a demonstration project nor introduced HPV vaccination, thus categorized as others (N.B., national rollout began in Tuvalu in September 2021 and the other two countries are preparing national introduction in the coming year, but only limited information was publicly available).…”

“…Challenges and barriers to HPV vaccination introduction and scale-up were obtained from nine countries (Table S2) [29,37,[44][45][46]49,50]. Their challenges were similar and thus categorized as: (1) difficulty in vaccine delivery (e.g., identification of target girls, reaching out-of-school girls, and cold chain management), (2) low community awareness and resistance, (3) limited coordination between stakeholders (e.g., the education sector, local governments, and civil society), (4) concern about cost and sustainable financing, and (5) insufficient vaccine supply.…”